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C Linical Practice Guidelines Paramedic

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C Linical Practice Guidelines Paramedic Guide ice line ct s ra P l a c P i n i l C 2014 Edition Paramedic Clinical Practice Guidelines CLINICAL PRACTICE GUIDELINES - 2014 Edition Practitioner Paramedic 1 Clinical Practice Guidelines CLINICAL PRACTICE GUIDELINES - 2014 Edition PHECC Clinical Practice Guidelines First Edition 2001 Second Edition 2004 Third Edition 2009 Third Edition Version 2 2011 Fourth Edition April 2012 Fifth Edition July 2014 Published by: Pre-Hospital Emergency Care Council Abbey Moat House, Abbey Street, Naas, Co Kildare, Ireland Phone: + 353 (0)45 882042 Fax: + 353 (0)45 882089 Email: [email protected] Web: www.phecc.ie ISBN 978-0-9571028-8-0 © Pre-Hospital Emergency Care Council 2014 Permission is hereby granted to redistribute this document, in whole or part, for educational, non-commercial purposes providing that the content is not altered and that the Pre-Hospital Emergency Care Council (PHECC) is appropriately credited for the work. Written permission from PHECC is required for all other uses. Please contact the author: [email protected] 2 Clinical Practice Guidelines CLINICAL PRACTICE GUIDELINES - 2014 Edition TABLE OF CONTENTS FOREWORD ............................................................................................................... 4 ACCEPTED ABBREVIATIONS ................................................................................. 5 ACKNOWLEDGEMENTS ......................................................................................... 7 INTRODUCTION ........................................................................................................ 9 IMPLEMENTATION AND USE OF CLINICAL PRACTICE GUIDELINES .......... 10 CLINICAL PRACTICE GUIDELINES INDEX ....................................................................................................................... 12 KEY/CODES EXPLANATION .................................................................................. 14 SECTION 1 CARE PRINCIPLES ............................................................................. 15 SECTION 2 PATIENT ASSESSMENT .................................................................... 16 SECTION 3 RESPIRATORY EMERGENCIES ........................................................ 21 SECTION 4 MEDICAL EMERGENCIES ................................................................ 26 SECTION 5 OBSTETRIC EMERGENCIES ............................................................. 53 SECTION 6 TRAUMA .............................................................................................. 59 SECTION 7 PAEDIATRIC EMERGENCIES ........................................................... 70 SECTION 8 PRE-HOSPITAL EMERGENCY CARE OPERATIONS .................... 95 SECTION 9 TREAT & REFERRAL ......................................................................... 100 Appendix 1 - Medication Formulary .............................................................. 103 Appendix 2 – Medications & Skills Matrix ................................................... 129 Appendix 3 – Critical Incident Stress Management .................................. 136 Appendix 4 – CPG Updates for Paramedics .................................................. 138 Appendix 5 – Pre-Hospital Defibrillation Position Paper .......................... 146 3 Clinical Practice Guidelines FOREWORD The role of the Pre-Hospital Emergency Care Council (PHECC) is to protect the public by independently specifying, reviewing, maintaining and monitoring standards of excellence for the delivery of quality pre-hospital emergency care for people in Ireland. The contents of this clinical publication are fundamental to how we achieve this goal. Clinical Practice Guidelines have been developed for responders and practitioners to aid them in providing world-class pre-hospital emergency care to people in Ireland. I would like to thank the members of the Medical Advisory Committee, chaired by Dr Mick Molloy for their efforts and expertise in developing these guidelines. The council acknowledge the work of the PHECC Executive in researching and compiling these Guidelines, in particular Mr Brian Power, Programme Development Officer. I also commend the many responders and practitioners whose ongoing feedback has led to the improvement and creation of many of the Guidelines herein. The publication of these Guidelines builds on the legacy of previous publications and marks yet another important milestone in the development of care delivered by responders and practitioners throughout Ireland. Despite the difficulties faced by responders and licensed service providers, I am proud that they continue to develop their skills and knowledge to provide safer and more effective patient care. __________________ Mr Tom Mooney, Chair, Pre-Hospital Emergency Care Council 4 Clinical Practice Guidelines ACCEPTED ABBREVIATIONS Accepted abbreviations Advanced Paramedic .................................................................................................. AP Advanced Life Support ............................................................................................... ALS Airway, Breathing & Circulation ............................................................................... ABC All Terrain Vehicle ......................................................................................................... ATV Altered Level of Consciousness ................................................................................. ALoC Automated External Defibrillator ............................................................................ AED Bag Valve Mask ............................................................................................................. BVM Basic Life Support ........................................................................................................ BLS Blood Glucose ................................................................................................................ BG Blood Pressure ............................................................................................................... BP Basic Tactical Emergency Care ................................................................................. BTEC Carbon Dioxide .............................................................................................................. CO2 Cardiopulmonary Resuscitation ............................................................................... CPR Cervical Spine ................................................................................................................ C-spine Chronic Obstructive Pulmonary Disease ................................................................ COPD Clinical Practice Guideline ......................................................................................... CPG Degree .............................................................................................................................. o Degrees Centigrade ...................................................................................................... oC Dextrose 10% in water ............................................................................................... D10W Drop (gutta) .................................................................................................................... gtt Electrocardiogram ........................................................................................................ ECG Emergency Department ............................................................................................... ED Emergency Medical Technician ................................................................................ EMT Endotracheal Tube ........................................................................................................ ETT Foreign Body Airway Obstruction ............................................................................ FBAO Fracture ........................................................................................................................... # General Practitioner .................................................................................................... GP Glasgow Coma Scale ................................................................................................... GCS Gram ................................................................................................................................ g Milligram ........................................................................................................................ mg Millilitre .......................................................................................................................... mL 5 Clinical Practice Guidelines ACCEPTED ABBREVIATIONS (contd) Millimole ........................................................................................................................ mmol Minute ........................................................................................................................... min Modified Early Warning Score ................................................................................ MEWS Motor Vehicle Collision ............................................................................................. MVC Myocardial Infarction ............................................................................................... MI Nasopharyngeal airway ........................................................................................... NPA Milliequivalent ..........................................................................................................
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